Box 8 Methods of administering rituximab
Precautions Vaccination of patients against influenza and pneumococcus can be useful It is also useful for preventing pneumocystis systematically throughout the entire treatment and in the following months (practically speaking, until immunological reconstitution) Premedication Administer about 60 min prior to starting each infusion of rituximab: Methylprednisolone (Solu-Medrol®): 100 mg in a vial of 50 ml of glucose 5% solution to run in 10 min Paracetamol: 1 g by direct intravenous injection Dexchlorpheniramine (Polaramine®): 5 mg by direct intravenous injection Induction treatment Rituximab induction treatment is administered by infusion at a dose of 375 mg/m2 on days 1, 7, 14, and 21, after premedication performed prior to each infusion First infusion: it is recommended to start infusion at a rate of 50 mg/h; after the first 30 min, the infusion rate may be increased in steps of 50 mg/h every 30 min, until reaching a maximum rate of 400 mg/h Second infusion: initial rate should be 100 mg/h, then increased in steps of 100 mg/h every 30 min, until reaching a maximum rate of 400 mg/h Maintenance treatment Once remission has been achieved, infusion of 500 mg of rituximab is administered on days 1 and 15, then every 6 months |  |